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The Appointment GAP in healthcare (and why we need a new type of practitioner) - Blog Image

The Appointment GAP in healthcare (and why we need a new type of practitioner)

BY: Andrea Nakayama

DATE: 2019-08-02

Our healthcare system is riddled with GAPS. GAPS in care, understanding, time, finances, and more. Both patients and practitioners suffer from these GAPS, and it’s time we fill them. To do so, we need to bring diet and lifestyle modification to the forefront of care.

Last week we dove deep into the Knowledge GAP—the chasm patients fall into when they lack complete understanding of what’s going on in their bodies, what actions they can take in their everyday to make sustainable change, and what they need to know in order to advocate for themselves in the system.

Another GAP that deserves our attention is the Appointment GAP. This GAP is multifaceted, and critically impacted by specific challenges our taxed healthcare system is already trying to address.


It’s estimated that between 5 and 40% of appointments in healthcare offices are no-shows, depending on the field. A no-show is constituted as no cancellation and no arrival.

There are a number of reasons for no-show appointments:

– Patients are discouraged. It can take over 18 days to get a routine appointment with a doctor. For specialty doctors—whether they be Functional or Integrative physicians or holistic docs that narrow their practices to one particular condition or ailment—it could take months or even years!

– Patients are more than their symptoms. Anxiety, real-life logistical challenges, and even knowledge or literacy regarding the reason for the appointment can lead to no-shows. When it comes to chronic health challenges, it will more likely be one of those initial reasons, as the patient has been waiting for a very long time!

– Patients have pockets. Another reason appointments are skipped is because of finances. When people find out the cost of the services they’re pursuing in medicine, nearly 50 million of them will opt-out for fear of the impending pay-out.

Where does this leave those patients?

Sick. Tired. Frustrated. And just not getting better.

15-Minute Visit

Doctor’s visits are actually said to be more like 7-minutes these days, but we’ll give them 15 for the moment.

15 minutes to examine, evaluate, diagnose, and prescribe.

No time to learn a patient’s history beyond the checked boxes cataloging familial disease trends and the individual’s personal history with procedures and medications.- No time to truly listen to the patient.

No time to glean what they’ve done on their own to try and resolve their condition.

No time to understand their diet and lifestyle habits—even if they do happen to know that diet and lifestyle modification matter.

No time to learn their fears, hopes, inspirations and intuitions about their own bodies.

What’s more, these 15-minute visits are often many months apart. Even patients with chronic conditions often don’t see their General Practitioner more than twice a year.

This begs the questions:

  • What are patients doing in the 6 months (or more) between doctor visits?

  • If we’re leaving our healthcare in the hands of a 7-15 minute doctor visit once or twice a year, isn’t there a need for another type of care that sits in the GAP between those visits?

The Appointment GAP

This brings me to the main facet of the Appointment GAP. Patients do not know how to care for themselves between visits because there is a glaring GAP in guidance.

And how could they be expected to know?

The practitioners they’re seeing barely have the time to get beyond a list of symptoms, and they’re not trained to give personalized recommendations on what patients can do in their every day to improve their health. This creates a huge GAP between the care that’s given and the care that could be given.

In addition, there is an incredible amount of time (in fact, most of the time) between doctor’s visits where self-care is the only care being given.

This is where you come in.

Functional Nutrition Counselors fill the Appointment GAP (and many others!), empowering patients to regain ownership over their own health, learning to implement the right kind of self-care, and finally guiding them toward resolution.

Your first step to join the Resolution is easy. Download my ebook—Roadmap to Resolution: Your Blueprint for Thriving in Practice by Addressing the Root Causes of Chronic Illness—and see just how important you are in this new healthcare paradigm.

Related Blog Posts

The Knowledge GAP in medicine (and how you can fill it)
What’s missing in healthcare
How functional nutrition became my life’s purpose
Functional Nutrition Counselor

Andrea Nakayama

By: Andrea Nakayama, FxNA Founder & Functional Medicine Nutritionist

Functional Nutrition Alliance provides the comprehensive online Functional Nutrition training in the Science & Art of the Functional Nutrition practice. Learn to address the roots of your clients’ suffering with client education, diet & lifestyle modifications.


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